Tag Archives: pneumonia

Infographic highlights potential out-of-pocket costs for patients requiring COVID-19 hospitalization

Although it is too early to analyze actual healthcare cost data for those who have been treated for COVID-19 in the United States, historical data from patients who have sought medical attention for influenza or pneumonia may be informative for understanding patient out-of-pocket costs due to treatment for COVID-19.

This infographic, based on Milliman’s recent paper, “Potential out-of-pocket costs for patients requiring hospitalization for COVID-19,” depicts what hospital costs could look like for patients admitted for COVID-19, broken down by insurer type, geography, and age.

How will the coronavirus pandemic impact patients’ out-of-pocket costs?

The unique structure of the U.S. healthcare system means that the out-of-pocket costs for patients requiring hospitalization due to COVID-19 can vary substantially among those with different types of health insurance. In addition, costs to those of different age groups, living in different parts of the country, experiencing different levels of severity, or facing the illness at different times of the year will also vary substantially.

Although it is too early to analyze the healthcare cost data for those who have been treated for COVID-19 in the U.S., historical data from patients who have sought medical attention for influenza or pneumonia may be informative for understanding out-of-pocket costs resulting from COVID-19 treatment. The biological and clinical characteristics of COVID-19 differ from other respiratory infections, but the signs and symptoms that necessitate hospitalization and intensive care for severe cases of the disease are also seen in severe cases of other respiratory infections.

In this report by Milliman’s Stoddard Davenport, healthcare claims data from three large national research databases is used to investigate the variation in out-of-pocket costs for patients who historically experienced acute inpatient hospitalizations involving treatment of acute respiratory infections (pneumonia and influenza). In this analysis, the focus is exclusively on cases that required hospitalization.

Economic impact of community-acquired pneumonia in the employed population

Community-acquired pneumonia (CAP) is frequently associated with the very young and the elderly but is a largely under-recognized burden among working-age adults. Although the burden of CAP among the elderly has been established, there are limited data on the economic burden of CAP in the employed population.

This study assesses the economic impact of CAP in the United States in working-age adults from an employer perspective by estimating the incidence rate and costs of healthcare, sick time, and short-term disability for this patient population and recommends prevention strategies that may reduce the morbidity and costs associated with CAP among working-age adults, especially those with comorbidities.

This research was first published in American Health & Drug Benefits, Vol. 6, No. 8 (September/October 2013).